Transcript Overview of the CNC initiative

The New Zealand Cancer Nurse
Coordinator Initiative
Natalie James
National Nurse Lead
May 2013
PREPARED BY
Welcome to the role…
• The Cancer Nurse Coordinator role aims to:
• Improve patient care through
o timely diagnosis and initiation of treatment
o continuity of care
o facilitating a quality experience, equity and
patient and family empowerment
• Service improvement
• Workforce development
CNC’s - Specialty practice
Evolving Practice…
• These Cancer Nurse Coordinator roles support a new
model of nursing care
o Collaborative practice
o Local / Regional / National
o Evaluation
• Essentially establishing key functions or components of
the role
o Specialised skills and processes
o Resources and tools
o Plan of care / pathways
Building on what is known…
Established modes of care
•Canada
•Australia
•USA
•UK
Building on work of others
• Needs Assessment – Who are the population to be
served?
• High risk
• Rare cancers
• Multiple comorbidities
• High volume
• Groups – tumours, age geography
• Where do patients come from
• What are the existing resources
(Crane-Okada, 2013)
Building on work of others
Validation of a framework to clarify key role and function
(Fillion et al, 2012)
Facilitating continuity of care
• Continuity of information (medical)
• Management continuity –consistent approach
• Relational continuity – therapeutic relationship
Promoting patient and family empowerment
• Active coping
• Cancer self-management
• Supportive care
New Zealand roles
44 cancer nurse coordinators have been appointed in parttime and full-time positions across 16 DHB’s
4 approaches
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Generalist
Tumour stream
Population group
Stage of cancer, clinical need
New Zealand roles
• CNC’s must remain mindful approach to care
coordination should include:
• Equity lens
• Consumer view
• Provider engagement
Supporting role development
Communication and collaborative practice:
• Newsletter – national newsletter for CNC’s
o topical information
o Faster Cancer Treatment info
o resources
• Website dedicated CNC webpage
o contact information and profiles
o organise resources and tools
o support orientation
Supporting role development
• Regional Meetings
o provide peer support, review systems and processes,
progress initiatives
o education
o formal process
• National Forum / Meeting
o support national collaboration
o highlight successful initiatives
o review tool development
Supporting role development. .
• Successful initiatives are promoted and will be shared
nationally
• Ministry and Lead Nurse will support development of
tools resources
• High level of interest and protocol around sharing
outcomes and stories
National Identity - Branding
Tools and Resources
•Assessment and triage
•Hand-held records
•Identification of a
complex patient
•MDM communication
•Health information
•Screening for distress
and support need
assessment
•Mapping the patient
journey
•Referral processes
•Orientation of new
CNC
The National Nurse Lead
• Support implementation of the roles
o National consistency / regional approach
• Professional leadership
• Lead development of tools
• Clinical Leadership to champion service improvements
Cancer nurse coordinator evaluation
Evaluation Purpose
The evaluation will assess implementation of the Initiative against two
overarching aims:
Improving the experience for patients, including their
family/whānau, with cancer or suspected cancer.
Improving overall access and timeliness of access to diagnostic and
treatment services for patients with cancer.
Cancer nurse coordinator evaluation
Evaluation Framework
The evaluation has two components:
Process evaluation – reviewing how the Initiative was implemented
and operated. This will involve an in-depth assessment of the
initiative activities during the development stages and operation of the
initiative over three years
Impact evaluation – assessing whether the Initiative achieved its
goals and objectives, measuring the value added to service users and
families/whānau, health professionals and regional cancer programme
development and utilisation.
.
Cancer nurse coordinator evaluation
Proposed data collection
The evaluation will use a ‘mixed methodology’ approach to collecting
information.
It is anticipated that the four main data sources will be:
• patient clinical pathways case studies
• online stakeholder survey
• patient satisfaction survey
• analysis of Ministry/DHB datasets
Cancer nurse coordinator evaluation
Upcoming deliverables
• baseline report is due in July 2013
• first annual report is due in January 2014
• final evaluation report is due January 2016
Questions and Discussion